MEDICARE: REAL OPTICS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332H00000X	Eyewear Supplier		IA

General Provider Information

NPI Number	:	1396952834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REAL OPTICS INC

Provider Business Mailing Address
First Line	:	7025 HICKMAN RD
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50322-4843
Country	:	US
Telephone Number	:	515-270-6060
Fax Number	:	515-270-8512

Provider Business Practice Location Address
First Line	:	7025 HICKMAN RD
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50322-4843
Country	:	US
Telephone Number	:	515-270-6060
Fax Number	:	515-270-8512

Authorized Official
Title or Position	:	OWNER
Name	:	ISAK SIVE
Credential	:
Telephone Number	:	515-270-6060

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	08/22/2020

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Directions to “REAL OPTICS INC ” Practice Location

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